Aetiology of Psychiatric Disorders

Aetiology of Psychiatric Disorders

·        Predisposing factors: Determine a person‟s vulnerability to psychological distress.  Causes include:

o  Genetic endowment (eg strong genetic component in psychosis) 

o  Environment in utero ® minor damage to CNS 

o  Personality: combination of genetic, uterine development, childhood experiences (physical, psychological, social), adolescence. Particular personalities are prone to certain disorders. Eg early obsessional traits may ® obsessive-compulsive disorders

·        Precipitating Factors: Factors that occur shortly before the onset of the disorders and are likely to have caused it. Eg: 

o  Physical: hypothyroidism, drugs, drugs of abuse, head injury (either direct disturbance or due to associated stress)

o  Psychological: eg loss of self-esteem owing to relationship or financial catastrophe

o  Social: eg moving house, changing job, family disturbance

·        Perpetuating factors: Factors that prolong the course of the disorder: eg secondary demoralisation

·        Psychiatric aspects of physical illness: 

o  Most common psychiatric illnesses in physical illness are mood disorders and acute organic mental disorders 

o  Occurs in one of three ways:

§  Psychological distress can precipitate mental illness

§  Physical distress can cause psychological ill-health (as can the medicines for physical disease) 

§  Physical and psychological disorders may exist simultaneously and independently (especially in the elderly) 

o   Pain: a common medical symptom. Can cause (eg head, neck, lower back, abdomen, genitalia) or arise from psychological disturbance (eg facial pain – antidepressant therapy can be effective).